Individual
JACOB VERNON RODGERS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
110 SKYLINE DR, RUSSELLVILLE, AR 72801-3362
(479) 968-1298
(479) 968-6053
Mailing address
1404 E 16TH ST, RUSSELLVILLE, AR 72802-2648
(479) 967-2022
(479) 967-5314
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Enumeration date
11/24/2009
Last updated
11/24/2009
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